Louisiana To Redesign Medicaid System, Focus on Creating ‘Medical Home’ for Low-Income Residents

Louisiana by mid-October will present to federal officials a Medicaid redesign plan that will include "major changes" in the way care is delivered and paid for in the state, Louisiana Department of Health and Hospitals Secretary Fred Cerise announced on Monday, the New Orleans Times-Picayune reports. Changes could include an expansion of Medicaid to cover more state residents, as well as an increase in out-of-pocket costs for beneficiaries in exchange for greater access to primary and preventive care, Cerise said. He added that charity hospitals -- which currently care for many of the state's uninsured -- will have a role in the new Medicaid system. Some critics have called for the elimination of Louisiana's charity hospital system. However, Cerise said, "This mantra that if you just close charity things will be fixed is not a realistic approach." The redesign will focus in part on the use of technology to better track results and reward hospitals and clinics that provide the best primary and preventive care. Cerise said that hospitals, nursing homes and others involved in the state's health care system will have a say in the redesign and that HHS Secretary Mike Leavitt will play a key role in the planning process. He noted that the state Senate is scheduled to take up a resolution to establish a 37-member "redesign collaborative" directed by Cerise to help craft the state's Medicaid waiver proposal. According to the Times-Picayune, Louisiana Gov. Kathleen Blanco (D) has said the state's Medicaid reform efforts should be modeled on a health care reform law recently approved in Massachusetts. However, Cerise said Louisiana faces more challenges than Massachusetts in its reform efforts because it has more low-income, uninsured residents (Moller, New Orleans Times-Picayune, 6/13).